Incidental intracranial findings in computed tomography of head injury cases

Abstract

Background: Cranial computed tomography scan is a routinely performed investigation in the evaluation of head injury cases. These scans detect the pathologies caused by the trauma as well as many unexpected incidental findings, the frequency of which are not known. Present study was conducted with the objectives to evaluate the patients with head injury using computed tomography and to determine the prevalence and significance of incidental findings on cranial scans. Material and Methods: This prospective study was conducted in Bangalore medical college and research institute from January 2018 to June 2019. A total of 600 consecutive patients of all age groups with history of head trauma undergoing cranial scans were included in this study. Computed tomographic scans of the brain are obtained from the vertex to foramen magnum level. Two series of axial data sets are obtained, one using soft tissue and another with bone-reconstruction algorithms. Collected data was entered in excel sheets and simple descriptive statistics were used to describe in the form of frequency tables and graphs. Results: The detected incidental findings were divided into two categories based on the plan of management. The mean patient age was 40+/-15.3 years, and male to female ratio was 2: 1. Incidental finding were identified in 28.5% of study sample which were mostly benign and non-critical. Arachnoid cysts (8%), megacisterna magna (5.8%) and calcified granulomas (8.8%) are the commonly noted incidental findings in category 1 and neuroparenhcymal atrophy (7.1%), infarcts (8.7%) and brain tumors (2%) are the commonly identified pathologies in category 2.